In a sense of trade-off disequilibrium, however, we found that aggressive pursuit of anemia control in the MHD patients may somehow aggravate the erythropoietin resistance [15] and the accumulation of ferritin secondary to anemia was cautioned by Kalantar-Zadeh et al. [28] who had also raised the crucial issue of ‘time discrepancies’ among competitive risk factors [18]. This evidence concerns the gene EPO and anemia (phenotype).